St. Joseph Health System
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Heart Attack (AMI)

A heart attack (acute myocardial infarction or AMI) is a life-threatening emergency. It occurs when an artery to the heart (a coronary artery) becomes blocked. Certain interventions and treatments have been demonstrated to improve patient outcomes and decrease mortality.
Evidence based indicators are aspects of care that have been scientifically proven to improve clinical outcomes.
There are nine such indicators used during an AMI event.

  • Aspirin at Arrival: Acute myocardial infarction (AMI) patients who received aspirin within 24 hours before or after hospital arrival. Since early administration of aspirin for heart attack patients greatly reduces complications and mortality, national guidelines recommend aspirin within 24 hours for those patients who are able to take the drug.
  • Aspirin Prescribed at Discharge: Acute myocardial infarction (AMI) patients who are prescribed aspirin at hospital discharge
  • ACEI or ARB for LVSD: Acute myocardial infarction (AMI) patients with left ventricular systolic dysfunction (LVSD) who are prescribed an ACEI or ARB at hospital discharge. For purposes of this measure, LVSD is defined as chart documentation of a left ventricular ejection fraction (LVEF) less than 40% or a narrative description of left ventricular systolic (LVS) function consistent with moderate or severe systolic dysfunction
  • Adult Smoking Cessation Advice/Counseling: Acute myocardial infarction (AMI) patients with a history of smoking cigarettes, who are given smoking cessation advice or counseling during hospital stay. For the purposes of this measure, a smoker is defined as someone who has smoked cigarettes anytime during the year prior to hospital arrival
  • Beta-Blocker Prescribed at Discharge: Acute myocardial infarction (AMI) patients who are prescribed a beta-blocker at hospital discharge
  • Median Time to Fibrinolysis: Median time from arrival to administration of fibrinolytic therapy in acute myocardial infarction (AMI) patients with ST-segment elevation or left bundle branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time
  • Fibrinolytic Therapy Received Within 30 Minutes of Hospital Arrival: Acute myocardial infarction (AMI) patients with ST-segment elevation or LBBB on the ECG closest to arrival time receiving fibrinolytic therapy during the hospital stay and having a time from hospital arrival to fibrinolysis of 30 minutes or less
  • Median Time to Primary PCI: Median time from hospital arrival to primary percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) patients with ST-segment elevation or left bundle branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time
  • Primary PCI Received Within 90 Minutes of Hospital Arrival: Acute myocardial infarction (AMI) patients with ST-segment elevation or LBBB on the ECG closest to arrival time receiving primary PCI during the hospital stay with a time from hospital arrival to PCI of 90 minutes or less
  • Statin Prescribed at Discharge: Acute myocardial infarction (AMI) patients who are prescribed a statin at hospital discharge

The "appropriate care score" (ACS) is also referred to as the "perfect care" score. It represents the percent of patients that receive ALL the individual indicators described above. At St Joseph, over 95% of patients with an AMI receive all the appropriate indicators of care.

AMI Appropriate Care Score

 

 

 

 

 

 

 

 

 

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